Provider Demographics
NPI:1871325969
Name:SH1 HAPPY WOODS OPCO LLC
Entity type:Organization
Organization Name:SH1 HAPPY WOODS OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE AND LICENSING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:564-203-3620
Mailing Address - Street 1:5101 NE 82ND AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6343
Mailing Address - Country:US
Mailing Address - Phone:360-254-9442
Mailing Address - Fax:360-254-1770
Practice Address - Street 1:3620 HAPPY WOODS CT
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-2925
Practice Address - Country:US
Practice Address - Phone:843-298-8888
Practice Address - Fax:843-293-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)